Efficacy of everolimus in ABO-incompatible kidney transplantation: A retrospective study

Abstract

Background: There are limited reports on the use of everolimus for maintaining immunosuppression in ABO-incompatible (ABOi) kidney transplantation (KT). As everolimus (EVR) is effective for preventing calcineurin inhibitor (CNI) nephrotoxicity without increasing the risk of chronic rejection and viral infection, we aimed to assess the efficacy of EVR in ABOi KT. Patients and methods: We retrospectively studied 22 patients who underwent KT and received EVR. Patients in the ABOi KT group (n=7) were compared with those in the ABO-compatible kidney transplantation group (ABOc KT; n=15). We recorded the frequency of CNI nephrotoxicity, chronic rejection, and viral infection in the 2 groups. Results: CNI nephrotoxicity, chronic rejection, and viral infection occurred in the ABOi KT and ANOc KT groups at rates of 28.3% (2/7 patients) and 13.3% (2/15 patients) (P=0.388), 28.3% (2/7 patients) and 26.7% (4/15 patients) (P=0.926), and 14.3% (1/7 patients) and 26.7% (4/15 patients) (P=0.517), respectively. Conclusion: Administration of EVR is effective in preventing CNI nephrotoxicity after KT. The rate of CNI nephrotoxicity was lower in the ABOc KT group than in the ABOi KT group. The rate of chronic rejection and viral infection was comparable between the groups. This study was conducted in a small cohort of patients. Hence, further evaluation with large sample sizes is necessary in the future to confirm the outcomes.